Melatonin is a circadian hormone with antioxidant properties that protects against myocardial ischemia-reperfusion injury. Genetic variations of the melatonin receptor 1B gene (
) play an important ...role in the development of type 2 diabetes, a risk factor for cardiovascular diseases. Accordingly,
polymorphisms are crucial in numerous disorders of the cardiovascular system. Therefore, the aim of the present study was to investigate a possible association of
polymorphisms with chronotype and susceptibility to myocardial infarction. The present case-control study included 199 patients with myocardial infarction (MI) (57% men) and 198 control participants (52% men) without previous cardiovascular diseases who underwent genotyping for the
polymorphisms rs10830963, rs1387153, and rs4753426 from peripheral blood samples. Chronotype was determined using the Morningness-Eveningness Questionnaire (MEQ). As estimated by the chi-square test, no significant association was found in the distribution of alleles and genotypes between myocardial infarction patients and controls. In addition, there was no association between
polymorphisms and chronotype in MI patients. As some previous studies have shown, the present negative results do not exclude the role of the
polymorphisms studied in the development of myocardial infarction. Rather, they may indicate that
polymorphisms are a minor risk factor for myocardial infarction.
AimThe aim of this study was to estimate the effects of a pulmonary rehabilitation programme (PR) on the functional capacity and respiratory muscle strength of patients with post-COVID ...syndrome.MethodsA cross-sectional study was conducted using hospital data on patients who participated in a pulmonary rehabilitation programme at the Clinic for Lung Diseases, University Hospital Centre Zagreb, Croatia, between January 2021 and December 2022. Data on the spirometry, respiratory muscle strength, and functional exercise capacity of patients were collected at baseline and three weeks after the start of rehabilitation. The study included 80 patients (43 females, 37 males) with a mean age of 51±10 years.ResultsA significant increase in respiratory muscle strength (P<0.001) was observed after pulmonary rehabilitation, with effect sizes ranging from small to large (Cohen's d from 0.39 to 1.07), whereas the effect for PImax expressed as a percentage was large (Cohen's d=0.99). In addition, the pulmonary rehabilitation programme significantly improved the parameters of the six-minute walk test in patients, and the parameters of lung function, FVC, FEV1, and DLCO also improved significantly after PR (P<0.05).ConclusionThe results showed that the pulmonary rehabilitation programme has clinically significant effects on functional capacity and respiratory muscle strength in patients with post-COVID syndrome.
Cilj: Analizirati demografska obilježja i distribuciju reumatologa u Hrvatskoj po vrstama specijalizacija i županijama te izračunati stopu na broj stanovnika na državnoj i županijskoj razini. ...Materijal i metode: Ovo presječno istraživanje temeljeno je na podatcima dobivenima od Hrvatskoga zavoda za javno zdravstvo o djelatnim reumatolozima zaključno do rujna 2022. godine. Analizirana je raspodjela reumatologa po dobi, spolu, vrsti specijalizacije, vrsti ustanove (akademska vs. neakademska) i lokaciji (županija). Stopa je izračunata na 100.000
stanovnika opće populacije. Rezultati: Od ukupno 77 reumatologa, 54% je fizijatara, 34% internista i 12% reumatologa s internističkim „deblom“. Žene čine 70% svih reumatologa. Prosječna dob je 50 godina, pri čemu je gotovo trećina (32,5%, N=25) starija od 55 godina. Gotovo dvije trećine (63,64%, N=49) radi u županijama s medicinskim fakultetima. Gotovo 90% internista i reumatologa radi u županijama s medicinskim fakultetima, a više od 50% u tercijarnim bolnicama. Reumatolozi rade u 15/21 županije (71%) i stopa na 100.000 stanovnika iznosi 1,99. Omjer najviše i najniže stope između županija iznosi 7 (Primorsko-goranska vs. Sisačko-moslavačka). Zaključci: Reumatologija je heterogena struka obilježena visokim udjelom žena i različitim profilima specijalističke izobrazbe. Stopa reumatologa na 100.000 stanovnika slična je europskom prosjeku, međutim razlike između pojedinih županija i regija jasno su izražene s tendencijom ka centralizaciji. Procjena dostupnosti reumatološke skrbi u hrvatskom zdravstvenom sustavu ograničena je zbog nedostatne informatizacije zdravstvenog sustava i
izostanka mogućnosti usporedbe određenih kvantitativnih pokazatelja zdravstvene skrbi.
Ischemic heart disease (IHD) morbidity and mortality indices, along with medical intervention rates, were analyzed among Mediterranean countries, Croatia, Slovenia, Spain, Italy, and France, in the ...pre-COVID period. Standardized IHD incidence and prevalence rates from 1990 and mortality rates from 1985 were obtained from the Global Burden of Disease Study 2017 and Health for All databases. Coronary artery bypass graft (CABG) and transluminal coronary angioplasty (TCA) rates in the 2011–2019 period were obtained from Eurostat. Trends were estimated with Joinpoint regression analysis. IHD mortality rates range from 13.6 to 74.3 for females and from 37.8 to 126.03 for males. IHD mortality rates in Croatia were 5.6-fold higher among females and 3.3-fold higher among males compared to France. All countries decreased standardized IHD prevalence and incidence rates, although the magnitude varied. The high-to-low ratio, Croatia vs. Spain, was 3.5-fold for CABG and 3.2-fold for TCA. Slovenia, as opposed to Croatia, reduced the gap for all medical indicators except for relatively high prevalence rates. Despite a significant rise in medical interventions in Croatia, ineffective clinical and public health initiatives have led to only modest declines in IHD mortality rates over the past decade.
ObjectiveLight chain deposition has been shown to be an important histologic hallmark with differences in isotype, characteristics and ratio of kappa and lambda light chains having a significant role ...in pathobiology, pathogenesis and prognosis of several glomerular diseases. However, there is, to the best of our knowledge, no study dedicated to evaluating light chain deposits in patients with lupus nephritis (LN).MethodsWe have conducted a retrospective cohort study to evaluate the characteristics and prognostic significance of light chain deposition profile in the kidney of subjects with LN. We have collected data on demographics, clinical and laboratory parameters and histopathology (light, immunofluorescent and electron microscopy). Lambda domination (LD) was defined as lambda intensity – kappa intensity ≥ +1. SLE was diagnosed using the ACR criteria and renal outcomes per KDIGO.ResultsA total of 56 patients with LN were followed up for at least one year after kidney biopsy (79% women, mean age at biopsy 38±13 years). Mean number of glomeruli per biopsy sample was 26±12. A total of 42 (75%) patients had light chain deposition in the glomerulus with 4 (7%) having restricted lambda chain deposition and none had restricted kappa chain deposition. Mean immunofluorescent intensity was 1.6±1.0 for lambda and 1.8±1.0 for kappa light chain. A total of 12 (21%) patients had LD in the glomerulus. When examining renal outcomes at one year post-biopsy, 55% of patients achieved complete response (CR), 30% achieved partial response (PR) and 15% had no response. There were no differences in achievement of remission (CR or PR) between patients with vs. without light chain deposition (88% vs. 71%, p=0.60) as well as between those with vs. without LD (90% vs. 83%, p>0.99).ConclusionLight chain deposition is prevalent in LN, but LD is much lower than in IgA nephropathy. While their deposition did not affect renal outcomes in our patients, light chains are an important factor to consider in LN patients, especially where restriction is present and further work-up, primarily for hematologic disease, is needed. Further investigation of the potential effect of pathobiologic characteristics of light chains in LN is warranted.
The aim of the study was to analyse the temporal and geographic distribution of radiologists, computed tomography and magnetic resonance scanners in Croatia. In this observational study we estimated ...radiologists’ number per 100,000 population for 1997, 2006, and 2017 and compared private and public CT and MR scanners between 2011 and 2018. We analyzed the availability of radiologists and scanners, and the relationship between the radiological workforce and economic strength among counties. The workforce increased significantly from 1997 to 2017 and was associated with economic strength categories in 2017. In 2018, there were more CT scanners in the public sector, while MR scanners were distributed evenly. In 2011, there was similar distribution of CT and MR between sectors, while in 2018 there were significantly more public CT scanners. Counties with a medical school had significantly more radiologists and MR scanners. The high-to-low ratios per CT and MR were 11 and 8.2, suggesting inequality of health care. Croatia significantly increased its radiological workforce; however, cross-county inequality remained. Counties with higher economic strength and medical schools have better availability of radiologists and equipment. To ensure the sustainable activity of the health care system, a precise estimate of supply and demand of radiology services is needed.
The expression of soluble adhesion molecules inter-cellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), besides activation of endothelial cells and transendothelial ...migration of leukocytes, play an important role in inflammation and progression of ischemic injury after acute stroke. The aim of this study was to determine serum levels of soluble ICAM-1 and VCAM-1 in patients with acute ischemic stroke and controls and correlate them according to etiological subtypes (thromboembolic or lacunar stroke), stroke severity and disability after acute stroke.
Hospital-based prospective study of acute stroke patients hospitalized between December 2008 and September 2009 at the University Hospital Sestre Milosrdnice in Zagreb, Croatia.
We enrolled 110 patients with acute ischemic stroke and 93 healthy individuals as controls. Serum concentrations of VCAM-1 and ICAM-1 were determined by means of quantitative sandwich enzyme immunoassay. Patients were classified according to etiological subtype, clinical severity of stroke and disability after stroke.
There was no significant difference between levels of soluble adhesion molecules VCAM-1 and ICAM-1 in patients and in controls. Levels of VCAM-1 were significantly higher in patients with thromboembolic stroke than in controls. There was no significant correlation between levels of soluble adhesion molecules VCAM-1 and ICAM-1 and stroke severity and disability. There was marked biological interindividual variability in all patient groups.
This study confirms the role of adhesion molecule VCAM-1 in the pathogenesis of acute thromboembolic stroke.
Cilj rada: Cilj istraživanja jest utvrditi opću i dobno-specifičnu stopu smrtnosti za akutni i ponavljajući infarkt miokarda (IM) po hrvatskim županijama za razdoblje od 2015. do 2019. godine, ...koristeći revidiranu europsku populaciju iz 2013. godine (RESP). Dodatni je cilj usporediti utvrđene stope s prosječnim stopama za Hrvatsku i EU, kao i istražiti povezanost između stopa i makroekonomskih pokazatelja. Materijal i metode: Izračunate su opće i dobno standardizirane stope mortaliteta za akutni i ponovljeni IM koristeći RESP kao i njegovu stariju verziju, europsku standardnu populaciju iz 1976. godine (ESP). Dobno standardizirane stope uspoređene su s prosječnom stopom u Hrvatskoj (2017. godine) i EU (2019. godine). Prosječna stopa smrtnosti u EU temeljena je na RESP-u i dobivena je iz baze Eurostat. Broj umrlih dobiven je od Hrvatskog zavoda za javno zdravstvo, a popis
stanovnika iz Državnog zavoda za statistiku. Analizirana je povezanost stopa mortaliteta i dvaju indikatora: bruto domaćeg proizvoda (BDP) i indeksa gospodarske snage Hrvatske gospodarske komore. Rezultati: Opće stope mortaliteta za akutni i ponovljeni IM iznosi od 72 do 91 (na 100.000 stanovnika), s velikim rasponom između županija od 35 do 120. Dobno standardizirane stope temeljene na RESP-u za većinu županija brojčano su više spram stopa temeljenih na ESP-u. U svim županijama dobno standardizirane stope nadilaze prosjek EU-a (do tri puta), a smrtnost u kontinentalnim županijama viša je od smrtnosti u obalnim županijama. Dok indeks HGK-a ne korelira značajno sa smrtnošću, BDP negativno korelira u muškaraca (r = -0.492, p = 0,023). Zaključci: Primjena RESP-a umjesto ESP-a preduvjet je za usporedbu dobno standardiziranih stopa smrtnosti s članicama EU-a. Usprkos međužupanijskim razlikama, stope smrtnosti u Hrvatskoj i dalje uvelike nadilaze prosjek EU-a.
Introduction: The urban road traffic accident (RTA) risks for the city of Zagreb, Croatia, from 1999 through 2000 were analyzed with the aim of reducing the increasing injury incidence.
Method: ...Simple and bivariate analysis using χ
2, odds ratio, and confidence interval of 95% was used to determine risks in three outcome groups: killed, severely, and mildly injured.
Results: There were 528 RTA victims consisting of 260 severely, 213 mildly injured, and 55 killed at the scene of an accident and during transportation. More fatal accidents occurred during night hours (OR
=
3.78; 95% CI, 2.08–6.85), on urban road links (OR
=
2.33; 95% CI, 1.30–4.19), and at exceeding speed limit (OR
=
2.56; 95% CI, 1.43–4.61). More people were injured than killed on urban junctions (OR
=
5.27; 95% CI, 2.21–12.57). The highest combined risk of dying or being severely injured was found in males, driving at excessive speed, on urban links, and during bad visibility (OR
=
16.15; 95% CI, 3.901–66.881).
Conclusion: These results will influence the urban traffic police enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.
Introduction: Clance Impostor Phenomenon Scale (CIPS) is the most common and psychometrically sound instrument used to measure the impostor phenomenon. The aim of this study was to translate and make ...a cultural adaptation of the CIPS from English into Croatian.
Materials and Methods: The translation process included two independent forward translations, combination of the forward translations into one single translation, back-translation, back-translation review, pre-piloting and drafting of the final translation after several revisions and minor adjustments by a professional reviewer.
Results: We noticed no semantic differences when comparing the original and the back-translated versions of the CIPS. Thus, the final translation was only slightly changed in comparison with the first version.
Conclusions: The version of the CIPS which was translated and culturally adapted into Croatian represents a reliable translation ready to be used in Croatia and Bosnia and Herzegovina.
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